Maternal and Neonatal Factors Associated with Neonatal Hyperbilirubinemia at a Tertiary Care Neonatal Unit

Abstract

Introduction: Neonatal jaundice is a prevalent condition affecting neonates globally, with significant incidence. If the serum bilirubin level in a jaundiced baby increases above the normal range for that age and gestation, it is referred to as hyperbilirubinemia. Pakistan has limited data on maternal and neonatal factors associated with hyperbilirubinemia.

Objective: To identify maternal and neonatal factors associated with hyperbilirubinemia among neonates admitted to a tertiary care hospital in Lahore.

Study design: Cross-sectional observational study

Place and duration of study: Neonatal Unit, Mayo Hospital, Lahore, over six months (December 2022- June 2023)

Materials and methods: This study was conducted on 183 neonates with hyperbilirubinemia using non-probability consecutive sampling. Data on maternal and neonatal factors were collected through medical records, clinical examinations, and interviews with mothers.

Results: Neonates with gestational age from 28 to 42 weeks and birth weights from 800 g to 4200 g were included. Key neonatal factors contributing to hyperbilirubinemia included bruises (12%), neonatal sepsis (70.5%), birth asphyxia (34.4%), UTI (4.4%), infant of diabetic mother (7.1%), polycythemia (1.1%), cephalhematoma (16.4%), and jaundice in siblings (24.6%). A significant association was found between hyperbilirubinemia and age at admission (p=0.000), birthweight (p=0.034), age at onset of jaundice (p<0.000), resuscitation (p=0.002), mode of feeding (p=0.002), and constipation (p=0.006). No significant association was found with the studied maternal factors.

Conclusion: Neonatal hyperbilirubinemia was found to be associated with age at admission, birthweight, age at onset of jaundice, resuscitation need, mode of feeding, and constipation. No significant association was found with the studied maternal factors.

Keywords: Neonatal hyperbilirubinemia, neonatal jaundice, maternal risk factors, neonatal risk factors.